Individual provider Active NPI

Clay Dargert, OT

  • Occupational Therapist
  • Manteno, IL
National Provider Identifier
1649862947
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.014033 Issued in IL
Practice address
1 Veterans Dr
Manteno, IL 60950-9466
Phone
(815) 468-6581
NPI assigned
Feb 8, 2021
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.014033 IL Primary

Addresses

Primary practice location

1 Veterans Dr
Manteno, IL 60950-9466

Mailing address

11025 W Dralle Rd
Monee, IL 60449-9429
Phone (815) 351-4858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240702000522 IL Practitioner - Occupational Therapist in Private Practice 1658815667 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7108 Marine Rd
Edwardsville, IL 62025-4282
Phone (618) 706-9759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.014033ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC Occupational Therapist CurrentSince Jul 1, 2024 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Jul 1, 2024 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Jul 1, 2024 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Jun 1, 2024 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Jun 1, 2024 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Jul 1, 2024 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1649862947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11025 W DRALLE RD",
            "city": "MONEE",
            "state": "IL",
            "postal_code": "604499429",
            "telephone_number": "815-351-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "city": "MANTENO",
            "state": "IL",
            "postal_code": "609509466",
            "telephone_number": "815-468-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARGERT",
        "first_name": "CLAY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.014033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteno, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.